Diabetes

Updated 27 February 2017

Psychiatric patients should be screened for diabetes

Fewer than one-third of mental health patients are screened for type 2 diabetes, despite an elevated risk for the disorder, according to a new California study.

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Despite guidelines, diabetes screening rates are low among adults with severe mental illness who take antipsychotic medications, researchers found.

Weight gain

In a new California study, fewer than one-third of mental health patients were screened for type 2 diabetes, despite an elevated risk for the disorder, the researchers reported in the online edition of the journal JAMA Internal Medicine.

Treatment with antipsychotic drugs contributes to this risk, the researchers explained.

This class of drugs includes clozapine (Clozaril), olanzapine (Zyprexa) and risperidone (Risperdal), among others.

Read: Antipsychotic drugs tied to diabetes

Anyone taking them should undergo diabetes screening every year, the American Diabetes Association says.

These drugs often cause weight gain, a contributing factor to type 2 diabetes, the study authors noted in a journal news release.

"To improve care for persons with serious mental illness, it will be necessary to break down the silos that separate the mental health and physical health care systems," journal deputy editor Dr Mitchell Katz wrote in a related editor's note. Katz is director of the Los Angeles County Department of Health Services.

Researchers looked at diabetes screening at different points between 2009 and 2011 among nearly 51,000 people in the California public mental health care system.

Read: Facts about mental illness

All had severe mental illness, such as schizophrenia or bipolar disorder, and were taking antipsychotic medicines.

The study found that about 30 percent of the patients received diabetes-specific screening; about 39 percent received nonspecific diabetes screening; and 31 percent received no screening.

Vulnerable population

The strongest factor associated with diabetes-specific screening was having at least one outpatient visit to a primary care provider during the study period.

Read: Antipsychotic drugs tied to diabetes in pregnancy

The findings support "efforts to integrate behavioural health and primary care", Dr Christina Mangurian, of the University of California, San Francisco, and colleagues wrote in the report.

"Growing evidence supports the value of screening for diabetes mellitus in higher-risk populations, such as those receiving treatment with antipsychotic medications, including first-generation and second-generation agents that commonly result in co-occurring obesity.

"Future studies should explore barriers to screening in this vulnerable population," the researchers concluded. 

Read more:

Myths and facts about mental illness 

Why coffee reduces risk of diabetes 

Antipsychotic drugs may triple kids' diabetes risk

 

Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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